• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (05/22/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
    The County of Los Angeles (03/30/25)
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  • Temporary, Utilization Review

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (06/06/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered Nurse ( RN ) Case ... Clinic inpatient admissions. Leads the multidisciplinary team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case… more
    Beth Israel Lahey Health (05/11/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible...IRR) Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California… more
    Alameda Health System (05/06/25)
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  • Utilization Review Nurse

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse ( RN ) who comprehensively conducts point of entry ... in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (06/06/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Current license to practice as a Registered Nurse in the State of Utah,...Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of… more
    University of Utah Health (05/30/25)
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  • RN - Utilization Review

    Baptist Memorial (Meridian, MS)
    Overview RN Utilization Review Weekender Job...Utilization Review Weekender Job Summary The Utilization Review Nurse is responsible for ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...experience Preferred/Desired: RN with Case Management or Utilization Review experience in a hospital or… more
    Baptist Memorial (04/22/25)
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  • Utilization Review Services…

    HCA Healthcare (Nashville, TN)
    …you want to join an organization that invests in you as a Utilization Review Services Registered Nurse ? At Parallon, you come first. HCA Healthcare has ... opportunity to make a difference. We are looking for a dedicated Utilization Review Services Registered Nurse like you to be a part of our team. **Job… more
    HCA Healthcare (06/11/25)
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  • Utilization Review Services…

    HCA Healthcare (Nashville, TN)
    …of nursing experience required + 1-4 years of relevant case management/ utilization review experience preferred + Registered Nurse - Currently licensed as ... **Introduction** Do you have the career opportunities as a(an) Utilization Review Services RN you...a registered professional nurse in the state in which he or she… more
    HCA Healthcare (06/06/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
    Beth Israel Lahey Health (04/29/25)
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  • RN - Utilization Review

    Baptist Memorial (Memphis, TN)
    Overview Purpose of Position and Scope of Responsibility Job Summary The Utilization Review Nurse is responsible for evaluating the medical necessity and ... appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse...clinical experience RN with Case Management or Utilization Review experience in a hospital or… more
    Baptist Memorial (06/14/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    Review experience.** Medical Coding experience is a plus! As our Utilization Review RN , you will be responsible for conducting comprehensive ... **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize… more
    Catholic Health Initiatives (04/23/25)
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  • Utilization Review Intake RN

    AdventHealth (Glendale Heights, IL)
    …60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ( RN ) is to use clinical expertise by analyzing patient ... of admission; and when warranted by length of stay, utilization review plan, and/or best practice guidelines,...capacity to prioritize multiple tasks and role components. + Registered Nurse ( RN ) Required +… more
    AdventHealth (06/13/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    …CCA-Auth & Utilization Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral health and substance use ... in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required Knowledge,… more
    Commonwealth Care Alliance (05/21/25)
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  • RN Registered Nurse

    Ascension Health (Tulsa, OK)
    …licensure at time of hire. **Additional Preferences** + Minimum of 3 years of RN experience + Utilization Review experience preferred **Why Join Our ... **Details** + **Department:** Utilization Review + **Schedule:** FT, Monday-Friday,...and regulations. **Requirements** Licensure / Certification / Registration: + Registered Nurse credentialed from the Oklahoma Board… more
    Ascension Health (06/14/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...a related field required; advanced degree or licensure (eg, RN , LCSW, LPC, LMHC, or CADC) preferred. + Excellent… more
    BriteLife Recovery (06/02/25)
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  • RN Manager - Utilization

    Ascension Health (Pensacola, FL)
    **Details** + **Department: Utilization Review ** + **Schedule: Full time days** + **Hospital: Ascension Sacred Heart Pensacola** + **Location: Pensacola, ... salary range at the time of the offer._ **Responsibilities** Manage effective utilization review processes, including management of patient statusing processes… more
    Ascension Health (06/04/25)
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  • RN Registered Nurse

    Ascension Health (Manhattan, KS)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . + Review admissions and service requests ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (05/23/25)
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  • Utilization Review Nurse

    Albany Medical Center (Albany, NY)
    …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... with Triad Team and health care team. Minimum Qualifications:* Registered nurse with a New York State...Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal… more
    Albany Medical Center (04/25/25)
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